Prothèse totale du genou associée à une « désostéotomie » : technique de l’ostéotomie après la mise en place de la prothèse

Same-stage total knee arthroplasty and osteotomy for osteoarthritis with extra-articular deformity. Part I: Tibial osteotomy, prospective study of 26 cases

“…Lerat et al (10) used a 10 tibial implant with either a short stem or anchoring pegs, which they inserted before performing the TO under the tibial implant, during the same stage. The clinical outcomes were good in 8 patients managed by TO reversal, although 1 patient required grafting to treat non-union and the mean time to healing was 5 months (10). Vielpeau et al (11) described TO via a lateral approach after eversion of the anterior tibial tuberosity.…”

Results and complications of single-stage total knee arthroplasty and high tibial osteotomy

“…Furthermore, a long-stemmed tibial implant cannot be used, as the HTO must be performed beneath the prosthesis. Lerat et al [16] proposed implanting a TKA with a short tibial stem and paying attention to maintaining good ligament balance prior to performing an HTO internally fixed with two staples. They reported osteotomy consolidation at five +/-four months and an improvement in KSS of 76 ± 21 points.…”

“…Zanone et al [5] treated four knees with stages III-IV arthrosis and pre-operative varus > 17°( mFTA 158-163º), with a medial-opening wedge HTO associated with TKA. At an average follow-up of 11 (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16) months, they reported one case of undercorrection and no nonunions. Of ten patients in their study, Radke and Radke [17] reported KSS improvement of 28 ± 15.25-80.60 ± 15.94.…”

Knee prosthesis and tibial or femoral osteotomy during the same surgery

“…The literature review regarding TKP and osteotomy in one surgery [3][4][5][6][7] shows that there are two main technical solutions:…”

“…Lerat [4] suggests carrying out osteotomy after prosthesis requiring the use of a tibial implant with studs or short rod and an osteosynthesis using clips or plate.…”